Real-world effectiveness of early molnupiravir or nirmatrelvir-ritonavir in COVID-19

[hapl808]

Thought this was an interesting study showing similar efficacy of molnupiravir vs Paxlovid. The PR on Paxlovid is much better, but I'm not convinced that it leads to different results?

I also wonder about these antivirals for long Covid or ME/CFS. Has anyone here taken molnupiravir or Paxlovid yet?

 

[hapl808]

Just realized there's a separate long Covid forum - happy for it to be moved if that's more appropriate.

https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(22)00507-2/

 

[Pyrrhus]

The problem with comparing Paxlovid and Molnupiravir is that the recommended dosing schedule for both of these is simply insufficient to suppress the virus.

I estimate that Paxlovid needs to be taken for 10-14 days in order to be effective, not the woefully inadequate 5 days that are currently recommended.

I estimate that molnupiravir needs to be taken at least 3 times a day in order to have any significant effect on suppressing the virus, although 4 times a day would be much better. The currently recommended 2 times a day is woefully inadequate for a direct acting antiviral (DAA) with such a short half-life.

 

[Gingergrrl]

I estimate that Paxlovid needs to be taken for 10-14 days in order to be effective, not the woefully inadequate 5 days that are currently recommended.

Do you think that someone taking Paxlovid for 5 days for Covid is better than not taking anything? Does it still have some efficacy even if it’s not (currently) allowed to be prescribed for longer than 5 days?

 

[Pyrrhus]

Do you think that someone taking Paxlovid for 5 days for Covid is better than not taking anything?

Assuming your doctor has determined that you are a candidate for Paxlovid, then I would say yes, it is definitely better than nothing at all.

Hope this helps.

 

[hapl808]

I estimate that Paxlovid needs to be taken for 10-14 days in order to be effective, not the woefully inadequate 5 days that are currently recommended.

I also found it fascinating that the guidelines are 5 days, but if I recall Fauci took a second course when his first one didn't fully knock it out. He didn't just wait it out but took an additional course (which of course none of us could get rx'ed from a physician).

 

[Hip]

@Nuno said that molnupiravir 800 mg twice daily for 5 days, in combination with GS-441524 (an active metabolite of remdesivir) at around 750 mg daily for three weeks, and the immune booster gepon 4 to 6 mg daily, rapidly moved him from moderate ME/CFS to remission.

That was in April 2022; I am not sure if he has slipped back into ME/CFS since then.

 

[Gingergrrl]

Assuming your doctor has determined that you are a candidate for Paxlovid, then I would say yes, it is definitely better than nothing at all. Hope this helps.

Thank you and that is definitely very helpful!

 

[Hip]

More specific detailed from Nuno:

He said that said that 3 weeks of GS-441524 moved him from moderate to mild ME/CFS.

Then some time later 5 days of molnupiravir placed him in remission.

He was also taking gepon at the same time as taking molnupiravir, and continued taking gepon for a few weeks after stopping molnupiravir.


Nune said:

Things can truly improve, I don't want to rush but I just went to the gym today, after 2 years. It's nearly 2 years since I became ill, and I am very happy to say that I've done baseline improvements with GS-441524, molnupiravir and gepon. Something about these 3 helped me a lot.

Side effects from molnupiravir was nausea and GI trouble like diarrhea. All passed as soon as I stopped.